Bupa
will begin measuring the effect of employing on-site general practice doctors at a handful of its aged-care homes around the country. The company hopes to improve the health and standard of care of its residents, while reducing medical expenses.

The company is well known as a private health insurer, No. 2 in the market behind Medibank. It is diversifying its business into aged care and healthcare services such as dental and optical.

The British-owned private company has more than 5600 residents housed in 61 aged-care homes around the country. Aged care is tipped to be a boom industry. In 2010 the National Health and Hospital Reform Commission estimated that by 2030 the number of elderly Australians requiring permanent residential care would double from 160,000.

Bupa Care Services Australia managing director Louis Dudley said the sector presents a “huge future" for the company. Bupa bought
Innovative Care
’s 1114-bed operations for an estimated $250 million this year, making it the country’s largest privately-owned aged-care provider.

But the rapidly ageing population also comes with challenges. Over the next 40 years the proportion of Australians aged over 65 is expected to double to 25 per cent, while growth in the traditional workforce age is expected to flatline.

“There’s going to be fewer resources to care for older people in many countries around the world," Mr Dudley said. “We’ve got to look for innovative ideas in an explosive market."

The company already has GPs working at six of its homes and will roll the scheme out to nine other homes over the next year. Having a doctor on hand is already leading to positive outcomes, Bupa Care Service’s medical services director, Daniel Valle Gracia, said.

“Because the GPs are spending most of their time in the care home with the residents they get to know the residents very well," Dr Valle Gracia said. “The chance of them identifying any change in their condition is much higher, which means we can start treatment sooner."

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Benefits of on-site care

The company is embarking on a two-year study of the new mode of care alongside researchers from the University of Tasmania. From a health perspective, the researchers will look at indicators such as rates of transfer to hospital emergency departments and falls due to polypharmacy, which refers the prescription of multiple medications that react badly with each other.

A health economist will also measure the cost of the scheme to Bupa, Medicare and the overall health system. Visits to the on-site GP will be bulk-billed under Medicare and reimbursements will go back to Bupa to fund some of their salary.

Bupa has committed to the two-year trial over 15 homes. Mr Dudley said the company will then assess whether it will roll the initiative out to other homes, but alternative options could include sharing GPs between locations or creating a medical panel that provides services to a cluster of homes.

As well as being able to book in for particular complaints, residents will visit the GP for monthly check-ups. Most Bupa homes have about 100 residents, which is an ideal workload for one full-time GP, Dr Valle Gracia said.

In homes where there isn’t a GP – the norm in most – Dr Valle Gracia said residents receive inconsistent care. Some residents have a GP that comes to visit, but many leave appointments too late, which leads to reactive care. “The most likely outcome of that is a transfer to hospital," he said.

A more regular and holistic approach to the health of the elderly can have a wide range of benefits. Dr Valle Gracia says at the homes already employing GPs, some residents have improved their mobility because they are taking more suitable regimes of prescription medication. Having a GP on site also means that the elderly can have more control over where they choose to die, he said.

Bupa also has growing businesses in optical and dental and has developed a number of online healthcare tools, such as the FoodSwitch smartphone app, which helps consumers choose healthier foods.

It makes economic sense for a health insurance company to have healthier members, because insurers pay out when members need to go to a hospital. Similarly, the longer members live, the longer an insurer can rely on recurring revenue from membership fees. The same could be said of an aged-care provider.